Development and Psychometric Validation of the Orthodontic Health Literacy Tool

Introduction: Over the past few years, there has been increasing emphasis on context?specific health literacy. However, no such context?specific psychometric tools are available with regard to oral health literacy. The aim of this study was to develop and validate an Orthodontic Health Literacy Tool (Orth?HLT). Materials and Methods: After development of initial item pool, the items were assessed for content validity. The final tool consisted of 22 items in the four domains of functional, communicative, critical orthodontic health literacy, and orthodontic knowledge. Orth?HLT was administered to a convenience sample of 642 subjects. The data were subjected to exploratory and confirmatory factor analyses using IBM SPSS Version 20.0 software and IBM SPSS Amos 26.0, respectively. Pearson’s correlation, independent samples t?test, and one?way analysis of variance were performed. Results: Orth?HLT demonstrated good face and content validity. The domain?specific internal consistency reliability values were optimal. Exploratory factor analysis on the items in all four domains resulted in a single factor solution. Four models were evaluated in the confirmatory factor analysis; the correlated factors model showed best model fit indices. Each domain of Orth?HLT showed moderate to strong positive correlation with Indian Oral Health Literacy Measure in Telugu indicating the convergent validity of the tool. Conclusion: Orth?HLT is the first context?specific oral health literacy tool and demonstrates strong psychometric properties, which could be used to evaluate orthodontic health literacy and articulate orthodontic health education materials in an informed manner.

A prospective study on use of Ilizarov external fixator for open fractures of Tibia

Introduction: Open fractures are more commonly seen in tibia as compared to other bones because of subcutaneous location and the tenuous soft tissue cover. There has been rise in open tibia fractures with increased road traffic accidents. Management of open tibial fracture remains controversial. Ilizarov external fixator is a better option for the treatment of these fractures. This study was conducted to evaluate the clinical outcome of open tibial fractures managed with an Ilizarov external fixator. Material & Methods: Twelve patients among those who presented to the emergency department with Type II, Type IIIA and Type IIIB Gustilo-Anderson type open tibial fracture were enrolled. All these cases were treated by Ilizarov external fixator and appropriate wound management. Active movements were started at the earliest after the surgery. Partial weight bearing with support was started from the second day after the surgery. Results: Mean age of the study subjects was 37.66 ± 8.77 years. Half of the patients had Type IIIB GustiloAnderson type fractures. The mean duration of fracture union was 7.1 months. Pin tract infection of the wires was the more common among complications. Excellent to good outcome was seen in 90% of study subjects. Conclusion: Ilizarov external fixator gives stable fixation of the open tibial fractures and allows better wound care. It also helps in early ambulation and rehabilitation of these patients.

Neutrophil to lymphocyte ratio and C- protein level as markers to predict deterioration in stable COVID-19 patients

The new Corona virus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). It is a highly communicable infectious disease [1]. Clinical manifestations of COVID-19 vary from asymptomatic to ARDS leading to death, it is important to differentiate between severe and non-severe cases. Early warning signs can be identified by several laboratory tests which are often expensive, time taking. Neutrophil-lymphocyte ratio (NLR), C- reactive protein (CRP) are two simple tests that can be used as markers for clinical outcome in COVID-19 patients. The aim and objectives of the study were to correlate patients clinical severity and CRP, NLR levels and to assess direct correlation between CRP levels and NLR. 101 patients who fulfilled the inclusion criteria were taken into the study. Patients are divided into mild, moderate severity based on WHO criteria and CBP, CRP were sent on the 6th/ 7th day of illness. Among the 101 patients, 93 were in mild group, 8 were in moderate group. The study group included subjects who aged between 18 years to 80 years of age. Plasma CRP levels were higher in moderate cases than in mild cases, and this difference was significant (p < 0.001). The mean NLR of moderate severity were significantly higher than those of mild cases (p-0.00003). Results showed that NLR was positively correlated with CRP levels.NLR and CRP are potential, reliable and easy-to-use predictors for deteriorating covid-19 infection. The integration of NLR and CRP may lead to improved predictions and help to triage patients at the time of hospital admission.

Study of portal vein diameter by ultrasound and its association with endoscopic findings in patients with liver cirrhosis

Background: The major cause of morbidity and mortality in patients with portal hypertension is due to oesophageal varices. Upper gastrointestinal endoscopy is considered best to detect varices earlier. It’s an invasive tool which is expensive and increased financial burden among patients. Hence this study is undertaken to find non-invasive indicators of oesophageal varices in cirrhosis patients with portal hypertension and to establish the role of portal vein diameter determined by ultrasonography in predicting the oesophageal varices. Aim and objectives: To detect non-invasive indicators of oesophageal varices in chronic liver disease, to determine the relation between oesophageal varices on upper gastrointestinal endoscopy and portal vein diameter, to determine other non-invasive parameters to identify oesophageal varices. Materials and methods: A cross sectional study on 45 patients, who were diagnosed to have chronic liver disease and are being presented to outpatient department and were admitted in Malla Reddy Institute of Medical Sciences, Suraram over a period of one year under department of general medicine. All the patients with chronic liver disease who underwent upper gastrointestinal endoscopy are included in the study. Results: 45 patients with cirrhosis of liver were included in the study, among which 32 were males and 13 were females with a mean age group of 46 years. On upper gastrointestinal endoscopy 87% of patients had oesophageal varices while other 13% of patients were normal. Mean portal vein diameterwas 13.8 mm and has a positive linear correlation with p<0.01 and positive predictive value of 95.25%. Majority of patients belonged to the platelet count group of 50,000 to 1lakh and its inversely co related to the severity of varices. Majority of patients with oesophageal varices had moderate splenomegaly. Conclusion: Ultrasonography of portal vein diameter and spleen size along with thrombocytopenia are reliable, inexpensive and easily reproducible non-invasive tool in predicting the presence of oesophageal varices and hence can identify the patients who require endoscopy on a prophylactic basis.

An insight into the altered ophthalmic dynamics during the COVID-19 pandemic

Purpose: The objective of this survey?based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods: The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results: A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic?appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion: The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department?based and surgical procedures in ophthalmology

Narrative Review of Nimesulide in Adults: Current Scenario

Nimesulide, a nonsteroidal anti-inflammatory drug (NSAID), has been used as an effective treatment regimen for patients aged >12 years for fever, acute pain, acute tendinitis, osteoarthritis and dysmenorrhea. It is reported to be a superior antipyretic and anti-inflammatory drug than paracetamol and aspirin, respectively, and is equal to any of the NSAIDs alone in terms of analgesia. This paper reviews the current scenario of nimesulide in adult patients, concerning clinical evidence, use in special population and expert opinion. Overall, in comparison to other NSAIDs, including coxibs, nimesulide has a promising overall efficacy, safety and tolerability profile, as well as a satisfactory benefit/risk evaluation.

Significance of Siddha Thirithoda Balancing Food Stuffs

The Siddha system of medicine is an ancient medical system, which provides ‘Holistic Health’. The word ‘Siddha’ originated from the word ‘Siddhi’ meaning achievement of perfection, eternal bliss and accomplishment. The Siddha system evolved based on ninety-six tools (96 Thattuvam) which include physical, physiological, psychological and intellectual aspects of every human being. Among the 96 tools, the five elements i.e. Pancha bootham namely Earth, Water, Fire, Air and Space are the fundamental units of everything in the human body and the cosmos. There are three vital life factors (Vaatham, Pittam, Kabham) responsible for good health. There is a relationship between these to maintain the body’s healthy. Any increase or decrease in humour causes diseases. Thirthoda sama porutkal (TSP) maintains these humour when we are using our regular diet. This article details the TSP to maintain the body healthy.

A case of subclavian steal syndrome

Subclavian steal syndrome is a relatively rare condition that results from occlusion of the subclavian artery proximal to the origin of the vertebral artery. This causes a reversal in the direction of the blood flow in the vertebral artery, leading to symptoms of vertebrobasilar insufficiency. In this article, we report a case of subclavian steal syndrome in a 55 year old male, who presented with giddiness, and variation in blood pressures in both upper limbs, was investigated with doppler and MR angiography. This article emphasises physical examination with discrepancy in pulse and blood pressure should bring attention to diagnosis of this syndrome.

Bioconversion of glycerol waste to ethanol by Escherichia coli and optimisation of process parameters

Biofuel is one of the best ways to reduce our dependence on fossil fuels. Ever since commercial biodiesel production began, waste glycerol, the biodiesel byproduct, has gained researchers’ interest, especially its recycling. Here, we explored using glycerol residue (carbon source) as a substrate in the fermentation process for ethanol production by Escherichia coli K12 in anaerobic conditions. The factors affecting the ethanol production was optimised by response surface methodology (RSM). Significant variables that impact the ethanol concentration were pH, temperature and the substrate, with a statistically significant effect (P <0.05) on ethanol formation. The significant factor was analyzed by the Box-Behnken design. The optimum conditions for bioethanol formation using glycerol as substrate was obtained at pH 7 and temperature 37°C. The ethanol productivity was 0.77 g/L/h. The ethanol concentration of 9.2 g/L achieved from glycerol residue was close to the theoretical value with the fermentation achieved at optimised terms.

Mapping the thickness of retinal layers using Spectralis spectral domain optical coherence tomography in Indian eyes

Purpose: This study aimed at establishing the normative data for the thickness of macular layers on Spectralis Spectral-domain optical coherence tomography (SD-OCT) in healthy Indian eyes and testing the effects of age, gender, central corneal thickness (CCT), and intraocular pressure (IOP) on such values. Methods: This cross-sectional study was done on 308 eyes of 159 healthy subjects. OCT scans were obtained using the posterior pole asymmetry scan protocol. From the thickness map, data were grouped into nine Early Treatment Diabetic Retinopathy Study (ETDRS) macular sectors. Correlation between retinal thickness and age/IOP/CCT was done using Pearson correlation. Correcting for age as a covariate, multivariate regression analysis was done to know which retinal layers showed significant differences in thickness between males and females. Results: The mean age was 46.06 ± 13.06 years (range: 20–75 years). Significant central subfield (CSF) thickening with age was noted in retinal nerve fiber layer (RNFL), inner nuclear layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL) (P < 0.04). The average thickness of the outer ring reduced with age in the ganglion cell layer (GCL)/IPL/INL (P = 0.001). Women had thinner inner and outer retinal thickness than men in all ETDRS rings (P < 0.001). There was no interocular asymmetry (P > 0.05) and no correlation between IOP/CCT and retinal layer thickness. Conclusion: In CSF, age-related thickening was noted in RNFL, IPL, INL, OPL, and ONL. The average inner ring thickness decreased with age in GCL and IPL and increased in the RPE layer. The average outer ring thickness decreased with age in GCL, IPL, and INL layers and increased in OPL. The average IR and OR thickness was significantly less in women compared to men in all sub-fields. There was no correlation between IOP/CCT and retinal layer thickness.

Evaluation of Effectiveness of Doxycycline as Empirical Therapy for Treatment in Acute Undifferentiated Febrile Illnesses in Routine Clinical Practice: A Retrospective, EMR-based, Real-world Study

Background: Tetracyclines, in particular doxycycline, are recommended for the treatment of patients with acute undifferentiated febrile illness (AUFI); however, real-world studies are scarce. Methods: This retrospective, multicenter, observational study reviewed electronic medical records (April 2018 to March 2021) of adult patients (outpatient and inpatient departments [OPD and IPD]) with AUFI, treated with doxycycline monotherapy (doxycycline group) or doxycycline in combination with other antimicrobials (combination therapy group), from 7 tertiary hospitals and clinics in India. Results: Overall, 473 patients were included; 73.8% and 26.2% patients were prescribed doxycycline alone or in combination with other antimicrobials, respectively. Defervescence was achieved in 65.6% and 57.3% patients, respectively at the second (8-14 days) follow-up visit. Clinical cure rate for symptomatic resolution varied between 89.6% and 100% in OPD settings. Time taken from treatment initiation to defervescence was 3.51 ± 3.16 days for the doxycycline group and 3.46 ± 3.07 days for the combination therapy group. Both groups showed improvements in body temperature in OPD settings (84.2% and 84.5%) as well as IPD settings (97.4% and 94.1%). Adverse events in OPD patients in both groups were nausea (7.8% and 8.7%), anorexia (1.6% and 33.0%) and dyspepsia (1.6% and 67.9%). Conclusion: Doxycycline appears to be a promising candidate for treating patients with AUFI due to its demonstrated real-world effectiveness and safety profile.

ICSI-A RAY OF HOPE IN DIFFERENT CAUSES OF INFERTILITY

Background- Different success rate of Intracytoplasmic Sperm injection (ICSI) are seen in different causes of infertility. In present study, we evaluated ICSI outcome in different causes of infertility. Materials and Methods- This is a retrospective study of ICSI cycles performed on 120 subjects at ART unit of Omega hospital Pvt Ltd, Nagpur between Jan 2020 and December 2021 to see ICSI outcomes in different causes of infertility. In present Results- study, out of 120 subjects, majority 52(43%) subjects were in the age group of 31-35 years followed by 49(41%) subjects in 25-30 years age group.Majority 55(46%) subjects were having infertility of 5-10 years, 52(43%) subjects were having infertility of <5 years. Majority 83(69%) subjects were having primary infertility. 45(37%) subjects had male infertility, 41(34%) subjects had ovulatory factor, 15(13%) subjects had unexplained infertility. 77(64%) subjects had biochemical pregnancies. 64(53%) subjects had clinical pregnancy by Ultrasound. 59(49%) subjects had live birth. 17(14%) subjects had abortion, 13 (11%) subjects had preterm labour. 3(2%) babies had to be admitted in NICU. Most important 74% mothers & 96% babies reported no complications. We found that ICSI is an effective option in couples with different causes of infertility. Therefore, Conclusion- physicians should have adequate training and required information regarding ICSI to improve the pregnancy outcomes reducing burden of infertility in the community.

Aggressive Central Giant Cell Granuloma in a Child: A Case Report and Review

Introduction: An aggressive variant of central giant cell granuloma in a paediatric patient is a localized benign osteolytic prolif- eration. The lesion consist of fibrous tissue with haemorrhage, hemosiderin deposits and presence of osteoclast-like giant cells with reactive bone formation. Clinically shown with rapid growth, resorption of roots, displacement of teeth and thinning or perforation of cortical bone, and marked recurrence. Case presentation: A 9-year-old boy reported with a 3 days history of asymptomatic soft tissue swelling in left mandibular pos- terior region which was diagnosed as central giant cell granuloma based on clinical, radiological and histopathological features. Management and Prognosis: Surgical resection was performed without any signs of recurrence on 9 months follow up. Conclusion: Prompt diagnosis and treatment of Central giant cell granuloma can significantly improve morbidity and long- term outcomes.

linical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors A randomized controlled trial

Background: Strip crowns are the first treatment of choice for restoring anterior teeth affected with early childhood caries. However, shade matching of resin composites is still an issue. The broad color matching ability of a recently introduced single shade composite, Omnichroma eliminates the need for shade-matching procedure, reduces composite inventory, and minimizes chair-side time. Aim: The aim is to evaluate the color match, color stability, and retention of one shade universal composite resin, Omnichroma and nanohybrid resin composite, Tetric-N-Ceram. Settings and Design: The study design involves split-mouth randomized controlled trial. Materials and Methods: The study was conducted on 25 children aged 3–5 years with multi-surface caries lesions in primary maxillary anterior teeth. Teeth were allocated to two groups randomly: Group 1 – One shade universal composite, Omnichroma (n = 25), Group 2 – Nanohybrid composite, Tetric-N-Ceram (n = 25). After caries excavation and tooth preparation, teeth were restored with corresponding materials using strip crowns. Color match at baseline, color stability, and retention after 6- and 12-month follow-up were evaluated using the Modified United States Public Health Services criteria. Statistical Analysis: The Mann–Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results: On comparison of Omnichroma and Tetric-N-Ceram groups, no statistically significant difference was observed in the color match at baseline (P = 0.716) as well as color stability (P = 0.575 at 6 months and 0.990 at 12 months) and retention (P = 0.153 at 6 months and 0.226 at 12 months) at both 6- and 12-month intervals. On intragroup comparison, the difference in the color stability at 6 and 12-month interval was statistically significant (P = 0.001) for both the groups, indicating that the color stability of restorations was better at 6-month interval compared to 12-month interval. In both Omnichroma and Tetric-N-Ceram groups, retention of restorations was better at 6-month interval compared to 12-month interval and this difference was statistically significant (P = 0.025 and 0.014, respectively). Conclusion: The clinical performance of Omnichroma in terms of color match, color stability, and retention was comparable to nanohybrid composite, Tetric-N-Ceram.

EVALUATION OF THYROID PROFILE IN THE INDIAN POPULATION WITH ALOPECIA AREATA

Alopecia areata is an autoimmune disease that causes hair loss. It is characterized by patchy hair loss that affects the scalp and other areas of the head, as well as the eyelashes, beard, and complete body hair. Alopecia areata manifests as a circular patch of hair loss that may progress to baldness of the entire scalp (Alopecia areata totalis) or loss of full body hair (Alopecia areata universals). The disease's etiopathogenesis is unknown, however autoimmunity appears to play a signi?cant role. Thyroid problems are frequently linked to AA, the most common of which is autoimmune Thyroid disorders. Aim: The goal of our research is to see if Alopecia Areata (AA) is linked to thyroid hormones (T3, T4, and TSH) and to evaluate the T3, T4, and TSH levels. Material and Methods: The present study included 150 A.A patients(cases) and 150 controls attended to Department of Dermatology in collaboration with Department of Biochemistry, LNMC & J.K Hospital, Bhopal. The levels of T3, T4 and TSH was estimated by ELISA. Result: The present study shows statistically signi?cant differences between patients and controls regarding Thyroid Hormones levels of TSH, T3 and T4. Conclusions: The ?ndings imply an association between Alopecia Areata and Thyroid function issues. Thyroid function abnormalities should be checked in all patients with alopecia areata, regardless of their clinical condition

Not-so-minimal for minimally invasive surgery

Sub?macular hemorrhage poses a potential threat to vision if left untreated. The preferred surgical technique to clear sub?macular hemorrhage includes vitrectomy followed by retinotomy using a 41G needle with subsequent injection of recombinant tissue plasminogen activator (r?tPA) followed by air/SF6 injection into the sub?retinal space. A malleable nature, increased resistance, and the cost of the 41G needle limit its use. We evaluated the safety and efficacy of a 26G needle for retinotomy as a supplement for the 41G needle in a series of six subjects with sub?macular hemorrhage. A slight modification in the procedure was done by injecting air into the sub?retinal space prior to the r?tPA injection. We found that our technique of using the 26G needle for retinotomy is safe and effective due to its stable nature and self?sealing properties. An air injection prior to r?tPA allows for increased bioavailability of the drug by preventing efflux due to its tamponading effect.

A cross-sectional and histological analysis to understand the cytological effects of cell phone radiation on buccal mucosa of children

Context: The ongoing pandemic has affected all the spheres of life and one of the severely affected avenues is the education of a child. The online education has seen an upward curve since the start of COVID-19 pandemic. Schools globally have adopted online class tutorials as the main method to impart education and directly increasing the screen time for a child. Aim: The aim of the present study was to evaluate the cytological effects of prolonged mobile phone usage on the buccal mucosa of children. Settings and Design: Stratified sampling was used for the selection of subjects for the study. After a questionnaire regarding the usage of a mobile phone was distributed among the parents of children. Among them, 90 children were selected on the basis of pattern and frequency of mobile phone usage in the child. Materials and Methodology: The children were divided into three groups based on the per day hours of viewing of mobile phone, i.e., Group 1: Usage of 1–2 h a day, Group 2: Usage of 3–6 h a day, and Group 3: Usage of >6 h a day. The time frame taken into consideration was 1 year after the pandemic started. This was specifically to understand the impact of the online education. Swab was obtained by using the conventional ice-cream stick method from the buccal mucosa. Statistical Analysis: The samples were subjected to histological and microscopical analysis to observe for cytological changes. One-way ANOVA was used to determine the statistical significance if any. Results: The results obtained clearly showed that Group 3 (>6 h usage per day) showed the highest number of cellular and chromosomal aberrations which was significant. Conclusion: The results indicated that impact due to the prolonged screen time on the buccal mucosa is significant. A direct proportionality was seen between the apoptotic changes and chromosomal aberrations and the number of daily hour usage.

Effect of preconditioning the fractured coronal fragments with remineralizing agents on fracture resistance of re-attached teeth

Background: Fragment re-attachment has been considered as one of the treatment modalities for the management of fractured anterior teeth. Hydration of fractured fragments aids in inhibiting the loss of ions and maintains vitality and esthetics. Aim: The study aimed to evaluate the effect of preconditioning the fractured fragments with remineralizing agents on fracture resistance of re-attached teeth. Settings and Design: This was an in vitro study. Materials and Methods: Sixty freshly extracted noncarious human permanent maxillary central and lateral incisors were randomly allocated into three Groups of 20 each: Group 1: 2% sodium fluoride (2%NaF), Group 2: casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), and Group 3: self-assembling peptide P11-4 (SAP). These were further divided into two subgroups of 10 teeth each, based on contact time with remineralizing agents, i.e., 30 min and 2 h. Fractured fragments were treated with remineralizing agents for a specified contact time and then re-attached with flowable composite resin. Force required to fracture the re-attached tooth was recorded in Newtons using universal testing machine. Statistical Analysis: Unpaired t-test, one-way analysis of variance test, and post hoc Tukey test were used for the statistical analysis. Results: A higher fracture resistance was noticed in fragments treated with 2% NaF (30 min- 215.6 N, 2 h- 188.5 N) compared to CPP-ACP (30 min- 141.3 N, 2 h- 111.1 N) and SAP (30 min- 134.8 N, 2 h- 149.5 N). At 30 min interval, it was found to be more in 2% NaF and CPP-ACP groups compared to 2 h. However, it increased with time in the SAP group. A statistically significant difference was found between the groups at both time intervals (P = 0.007 and 0.017). Conclusion: Preconditioning of fractured coronal fragments with 2% NaF showed higher fracture resistance compared to CPP-ACP and self-assembling peptide P11-4. Samples treated with SAP P11-4 exhibited good fracture resistance at 2 h contact time.

Clinical application of 3d printing technology for preoperative planning of thumb reconstruction / Aplicação clínica da tecnologia de impressão 3d para planejamento pré-operatório de reconstrução de polegar

ABSTRACT Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted "Excellent" satisfaction and three "Good", each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.

RESUMO Objetivo: Este estudo explorou a aplicação clínica do desenho pré-operatório preciso para impressão 3D e reconstrução do polegar, para ajudar no controle e melhorar função e aparência. Métodos: Estudo retrospectivo de 20 pacientes submetidos à cirurgia de colheita de transplante de dedo do pé e reconstrução do polegar entre janeiro de 2015 e dezembro de 2016. O modelo 3D do defeito do polegar foi confeccionado e impresso. As dimensões da pele e dos ossos da área doadora foram precisamente projetadas como referência para a operação cirúrgica, realizada de acordo com o modelo. Resultados: O reparo perfeito foi alcançado com aparência e função satisfatórias. Todos os polegares reconstruídos sobreviveram (taxa de sobrevivência de 100%). O acompanhamento foi de 3-9 meses. A dorsiflexão máxima foi de 8-30° e a flexão máxima foi de 38-58°. A discriminação sensorial de dois pontos foi de 9-11 mm. No total, 17 pacientes reportaram índice "Excelente" e três índice "Bom" cada para a função reconstruída do polegar e da mão, respectivamente. O índice de satisfação foi de 85%. Conclusão: O design digital pré-operatório e a impressão 3D de acordo com os locais doador e receptor permitiram uma operação customizada. A operação foi mais precisa, com bom aspecto. Nível de Evidência II, Estudo Retrospectivo.